COMPLICATIONS DURING A SUPRACLAVICULAR ANESTHESIA OF THE BRACHIAL PLEXUS WITH INTERSCALENE APPROACH

A hemidiaphragmatic paresis is one of the most frequently observed complications following the supraclavicular anesthesia of the brachial plexus with interscalene approach. In patients, crucially dependant on adequate diaphragmatic function, hemidiaphragmatic paresis may provoke acute respiratory disturbances. The aim of this study was to analyze the anatomical features the brachial plexus with regard of the anesthesia of specific areas of the shoulder and the upper limb.A dissection of the cervical and the brachial plexuses was done in human cadavers. We established that in some cases the phrenic nerve and the accessory phrenic nerve arise from the superior trunk of the brachial plexus. This type of anatomical arrangement significantly increases the risk of hemidiaphragmatic paresis during supraclavicular anesthesia with interscalene approach because the anesthetic tends to invade the supraclavicular space

Astrocyte heterogeneity under physiological conditions and after brain injury

There is a growing interest in astrocytes as glial cells in the central nervous system due to their important role in maintaining brain tissue homeostasis both under physiological conditions and after brain injury. A significant amount of evidence has been accumulated regarding their capacity to exert either pro-inflammatory or anti-inflammatory effects under different pathological conditions. In combination with their known high proliferative potential, they contribute not only to the limitation of brain damage and tissue remodeling but also to neuronal repair and the recovery of synaptic contacts in neurons. Moreover, reactive astroglia modulates the processes of neurogenesis, proliferation, and migration of neurons in the existing neural circuits in the adult brain. The identification of specific niche signals that regulate these sequential steps during adult neurogenesis may lead to the development of strategies for inducing functional neurogenesis in other areas of the brain after an injury or in degenerative neurological diseases

The role of microglia in ischemic stroke

Cerebral ischemic stroke is a disease that belongs to the group of acute vascular disorders of the cerebral circulation. It is considered a major cause of disability and mortality worldwide. It has been shown that the integrity of the blood-brain barrier is impaired after an ischemic stroke, and this is the key factor in brain damage. An inflammatory reaction occurs, which is provoked and maintained by bioactive substances released by endothelial cells, brain glial cells, and blood immune cells. Microglial cells are the first to respond to an injury; they get activated through a series of molecular mechanisms and transformed into diverse functional subtypes. Activated microglia can have both aggravating and beneficial effects regarding tissue remodeling and recovery after ischemia. In addition to their functions, activated microglial cells also differ in their morphology, gene expression, and protein profile. Their type can also vary depending on the distance from the ischemic lesion. Microglial plasticity, as well as the complex relationships of microglia with other cells in the central nervous system under physiological conditions and after ischemic stroke, have been studied mainly in experimental animals: rodents and primates. However, more information has been generated by in vivo studies of post-stroke patients, applying highly specialized imaging methods. Nevertheless, the obtained results are insufficient and ambiguous, but they are a good basis for developing strategies to influence the recovery process after ischemic brain injury

Postnatal cerebellar development in a mouse

The cerebellum is a part of the central nervous system, which plays an important role in cognitive functions, discriminative sensibility, and the coordination of voluntary movements. Its development takes place in two stages: prenatal and postnatal. The cerebellar germ originates from the rhombic lip. There are two major groups of cells: glutamatergic and GABAergic neurons, which are generated at different spatial-temporal intervals. In the postnatal period, Purkinje cells and their synaptic contacts undergo the most significant development. Another key point is the formation of anchoring centers and the foliation of the brain.The cerebellum is a part of the central nervous system, which plays an important role in cognitive functions, discriminative sensibility, and the coordination of voluntary movements. Its development takes place in two stages: prenatal and postnatal. The cerebellar germ originates from the rhombic lip. There are two major groups of cells: glutamatergic and GABAergic neurons, which are generated at different spatial-temporal intervals. In the postnatal period, Purkinje cells and their synaptic contacts undergo the most significant development. Another key point is the formation of anchoring centers and the foliation of the brain

Artefacts on Display: Museum Narrative for the Bulgarian National Revival Period

Bulgarian museums, which present the National Revival period, form a whole category of exhibitions, the specifics of which are recognizable to a wide range of audiences. Themessages in these museums are not entirely unknown; on the contrary - there are certain preliminary expectations for them, the answer to which leads to satisfaction from the visit. In the minds of many Bulgarians, visiting these exhibitions, as well as the satisfaction of this act, are "mandatory". The artefacts construct an idea of the dynamics of social development, in which the virtues of the "old" society are complemented by modern European ideas of the era, and innovations in the life of Bulgarians happen only for the better. The presence of the exhibits in the museums of the Bulgarian National Revival is completely subordinated to the general presentation idea. Their main function is to illustrate the specific topic - the photograph visualizes a figure or location, the document testifies to them truth, and the personal belonging evokes adoration. From this point of view, artefacts play a supporting rather than a catalytic role - instead of "items with history", museums show "history complemented by items"